I have hives. I get them when I am nervous or anxious. I find them very embarrassing, if I am speaking in public, and times I would rather not show my tension. I’m a 47 year-old healthy woman. I exercise for 45 minutes to an hour daily, and I am of average weight for my size. I eat well, get plenty of sleep, and lead a very busy life. If there were a pill I could take to eliminate these hives, I would be able to avoid having to cover my neck with clothing. Any suggestions? I get very flushed on the neck and sometimes the cheeks.
Hives, or urticaria, can be due to many things, but some people have the misfortune to get them when they are anxious, as you have described.
Hives usually are a symptom of an allergic reaction, and commonly occur with allergic reactions to medicines such as penicillin. Many cases are also attributed to food allergies, although it is often very difficult to pin down the precise food that is responsible, even with allergy testing.
But after weeding out the obvious drug or food allergies, there are still a large number of people who can only attribute their hives to nerves, or anxiety. Being put on the spot in public, having to perform or speak are all common inciting causes. The hives often appear on the upper chest and neck, and so are distressing to the sufferer, since they are so obvious to others.
There are a number of things that you might try to avoid this problem. Taking an antihistamine which does not make you sleepy, such as citirizine (Zyrtec) or loratidine (Claritin) may be sufficient to block the response. It should be taken one to two hours before a public appearance which is likely to make you nervous.
Many performers and musicians who suffer from stage fright take propanolol (Inderal), an antihypertensive, to block that anxiety. They find that propanolol does not interfere with their ability to perform but reduces the anxiety. I have no experience using this to treat urticaria due to anxiety, but it is so effective for stage fright that I think it might help.
It could even be combined with the antihistamine if necessary: 40-60 mg. of propanolol 1-2 hours before performing is a safe dose to start. Although it is an antihypertensive, when used as a single dose for performance anxiety it appears to have few side effects. Both propanolol and one of the antihistamines I mentioned will require a doctor’s prescription.